Checklists Can Reduce Fatal Medical Errors
Doctors and hospitals are reducing errors and saving lives with an occupational concept fast-food restaurants have long used: checklists. Surgical teams started creating standardized lists of questions to use in operating theaters. In turn, patients and their families are now taking their own checklists to the hospital.
All these lists are significantly improving medical results. They can keep doctors from skipping steps and making careless and potentially fatal errors, such as operating on the wrong organ.
The most famous checklist advocate is Atul Gawande, a Boston surgeon and an assistant professor at Harvard. In 2008, he introduced a surgery checklist in eight hospitals. The practice resulted in 36 percent fewer major complications and 47 percent fewer deaths. The findings led to his bestselling book, “The Checklist Manifesto: How to Get Things Right.”
Patients can also arm themselves with checklists from a second book – Martine Ehrenclou’s award-winning “Critical Conditions.” A Hearst Newspapers investigation last year found that roughly 200,000 Americans die every year from preventable medical errors and health care-associated infections. Ehrenclou believes patients can help prevent many of these infections and errors by asking the right questions and going through checklists with doctors and hospital staff.
The list, which is available on her Web site, advises patients to enlist a friend or family member as your advocate through the process. She also suggests asking each new medical professional caring for the patient to verbally repeat these items: name and birth date, diagnosis, current list of medications and dosages, and allergies to medications. It also suggests politely asking doctors and nurses to wash their hands and don gloves.
Dr. Gawande said many doctors will reduce errors simply by acknowledging they can make errors and need to work as a team.
“The most important component [of the checklist] has turned out to be making sure that everybody in the room has been introduced by name and that people just take a minute to discuss the case in advance,” he said in a Time magazine interview. “I introduced the checklist in my operating room, and I’ve not gotten through a week without it catching a problem. It has been really eye-opening. You just realize how fundamentally fallible we are.”
He said the checklists have also been useful for X-rays and other simpler procedures outside the operating room. They also can save time in hospitals rather than creating time-wasting busy work, as some doctors fear.